Probiotics and Oral Health
What do your toothbrush and
probiotics have in common?
Both are important for oral health.
I have previously discussed the many health benefits of probiotics, most of which have been related to the GI tract. This month I would like to review some of the reports on probiotics with regard to oral health.
Clinical studies have been carried out to determine whether probiotics can prevent or lessen common oral and dental diseases. The three disorders that I would like to review are dental caries, periodontal disease, and halitosis.
Dental caries, or cavities, are formed by bacteria. Streptococcus mutans is the most destructive bacterial strain in the mouth as it attaches easily to teeth and produces a lot of acid. It is able to ferment the sugars (carbohydrates) in our diet, especially those sweet foods that get caught on and between our teeth. During the process of bacterial digestion of the sugars, lactic acid is produced. Lactic acid creates an acid environment around the teeth which is able to destroy the enamel of our teeth. Initially, the damage is microscopic, but with time, the damage is able to penetrate deeper through the layers of the tooth causing a cavity to form which leads to decay.
Studies using orally-administered probiotics have found that certain strains can inhibit the growth of S. mutans1,2. A study done on children during their early childhood reported a significant reduction in caries after 7 months of daily consumption of probiotic milk. The conclusion was that probiotics seem to be a natural way to maintain dental health, and that daily intake of probioitcs in early childhood may result in less dental caries3.
Periodontal disease is an inflammation of the tissues that support the teeth. These tissues consist of our gums (gingiva), outer layer of the roots of our teeth (cementum), the bony sockets that anchor our teeth (alveolar bone), and the connective tissue supporting the roots and bony sockets.
The cause of the inflammation begins with bacteria, especially Streptococcus mutans and certain class of bacteria called anaerobes that create a biofilm or a plaque on the teeth which becomes calcified. If not removed, the plaque builds and causes inflammation in the surrounding teeth and the gums. With time, the gums recede and the bony socket becomes infected. Abscesses can form, and the teeth eventually fall out.
Studies have found that the bacteria causing periodontal disease could be regulated by applying a probiotic which inhibited their growth. A decrease in gum inflammation and bleeding was noted in those subjects given probiotics4.
These studies, like those for dental caries, are promising but have not yet proved that they can prevent periodontal disease.
Halitosis, or bad breath, is the condition when breath has an unpleasant odor. Halitosis is an embarrassing social problem more than it is a dental health problem. Approximately 80-90% of the causes of bad breath originate in the mouth. Again, this is a bacterial disorder. The back of the tongue is thought to be the most common site in the mouth where bad odors are produced. The posterior portion of the tongue is a common area where food debris can adhere to the surface. This area becomes an ideal site for bacteria to flourish and produce foul smelling gases.
Two studies have found that by administering probiotic bacteria, it was possible to suppress the odor-producing bacteria, resulting in a decrease in the foul smelling gases arising in the mouth5,6.
In summary, probiotics seem to be a potential therapy for maintaining oral health. Just like in the GI tract, maintaining a healthy balance of the bacteria flora in the mouth may help to prevent increased visits to the dentist. Probiotics are certainly not a substitute for the basic recommendations by the American Dental Association as follows:
- Brush your teeth twice a day with an ADA-accepted fluoride toothpaste. Replace your toothbrush every three or four months, or sooner if the bristles are frayed.
- Clean between teeth daily with floss or an interdental cleaner. Decay-causing bacteria still linger between teeth where toothbrush bristles can’t reach. This helps remove plaque and food particles from between the teeth and under the gum line.
- Eat a balanced diet and limit between-meal snacks.
- Visit your dentist regularly for professional cleanings and oral exams.
If you are prone to cavities, periodontal disease, or suffer with halitosis, it may be worthwhile to take a good probiotic such as EndoMune. If you wanted to take EndoMune for the purpose of dental health, I suggest you open the capsule and sprinkle the contents in a small glass of water and then swish and swallow.
1)Probiotics: contributions to oral health. Meurman JH, Stamatova I.Oral Dis. 2007 Sep;13(5):443-51. Review
2)Probiotics and oral healthcare.Teughels W, Van Essche M, Sliepen I, Quirynen M. Periodontol 2000. 2008;48:111-47
3)Probiotics and oral health effects in children.Twetman S, Stecksén-Blicks C. Int J Paediatr Dent. 2008 Jan;18(1):3-10.
4)Decreased gum bleeding and reduced gingivitis by the probiotic Lactobacillus reuteri. Krasse P, Carlsson B, Dahl C, Paulsson A, Nilsson A, Sinkiewicz G. Swed Dent J. 2006;30(2):55-60
5) A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters.Burton JP, Chilcott CN, Moore CJ, Speiser G, Tagg JR.J Appl Microbiol. 2006 Apr;100(4):754-64.
6)Inhibitory effect of Weissella cibaria isolates on the production of volatile sulphur compounds. Kang MS, Kim BG, Chung J, Lee HC, Oh JS.J Clin Periodontol. 2006 Mar;33(3):226-32.